More Effective CKD Strategy Could Have Health, Societal Benefits

Improvements in chronic kidney disease (CKD) diagnosis and treatment could lead to significant reductions in kidney replacement therapy and deaths, according to a new analysis.

The report is based on simulations comparing the current treatment paradigm in 8 countries with scenarios of improved diagnosis and treatment in those same countries. In addition to the health benefits, the study also suggested improved CKD care could lead to economic and environmental improvements. The study was published in KIREPORTS.1

The authors said the improvements simulated in their scenarios would have wide-ranging impacts on society. | Image credit: amazing studio - stock.adobe.com

CKD is estimated to affect as much as 13% of the global population, according to one study.2 Yet, the disease remains underdiagnosed and undertreated, according to the study authors.1 Undiagnosed CKD can have significant impacts on individual patients’ longevity and quality of life, they noted. However, CKD can also have major societal-level consequences. The investigators said CKD is estimated to contribute 2-3% of the annual healthcare costs of high-income countries.3 If CKD progresses to kidney failure, it can necessitate costly therapy like dialysis, which also brings a significant economic burden due to the treatment’s use of high amounts of energy, water, and single-use plastics.

The researchers sought to better understand the burden of CKD in hopes of illustrating the benefits of improved diagnosis and utilization of available treatment options.1

“A holistic assessment of CKD burdens and how these burdens may be impacted by policies designed to improve rates of detection and management of CKD is required,” they said.

The investigators used data from 8 countries—Australia, Brazil, China, Germany, the Netherlands, Spain, the United Kingdom, and the United States—to simulate CKD-related trends over a timespan of 25 years. The simulations included the potential impacts of various policy changes, including targeting screening of high-risk populations, increased diagnosis of the disease, and better adherence to evidence-based treatment guidelines. Those guidelines include interventions aimed at protecting the kidneys and lowering glucose and lipids, as well as antihypertensive and lifestyle interventions. The simulated outcomes of those hypothetical interventions were then compared to scenarios in which the current practices were continued unchanged.

The simulations suggested that a 75% improvement in the use of guideline-directed medical therapies would lead to reductions of dialysis (–3.2% to –23.2%), cardiovascular events (–12.2% to –41.4%), and death (–2.3% to –9.3%) over the course of 10 years, compared to current practice. Delays in disease progression would decrease the cost of kidney replacement therapy by between –2.5% and –19.4%, and the environmental burden associated with CKD would drop by –2.7% to –21.2%. They said all of the scenarios led to increased benefits at the 25-year time horizon.

The authors said the improvements simulated in their scenarios would have wide-ranging impacts on society.

“Significant societal benefits were predicted, including gained net workdays, gross domestic product contribution, full-time equivalents, and tax revenue over 10 and 25 years compared with current practice for all treatment scenarios,” they wrote.

The authors said their simulations represent actionable insights, since there are already effective interventions available for people with CKD. One problem, they said, is a lack of attention from policymakers. They noted that only half of the countries surveyed in the Global Kidney Health Atlas listed CKD as a health priority, “and even fewer have CKD-specific policy plans.”4

The investigators said governments and public health entities should do more to increase awareness and detection of CKD and to promote adherence to guideline-directed medical therapies.1

“The results from the present study encourage urgent strategic action through policy implementation that would lead to improved detection and treatment of patients with CKD to mitigate the growing burdens of CKD on patients, caregivers, health care systems, and the environment alike,” they concluded.

References

1. Tangri N, Priest S, Zara A, et al. Impact of improved diagnosis and treatment on holistic CKD burden. Kidney Int Rep. 2025;10(8):2608-2620. doi:10.1016/j.ekir.2025.05.039

2. Hill NR, Fatoba ST, Oke JL, et al. Global prevalence of chronic kidney disease - a systematic review and meta-analysis. PLoS One. 2016;11(7):e0158765. doi:10.1371/journal.pone.0158765

3. Li PK, Garcia-Garcia G, Lui SF, et al. Kidney health for everyone everywhere—from prevention to detection and equitable access to care. Kidney Med. 2020;2(1):5-11. doi:10.1016/j.xkme.2020.01.002

4. Neuen BL, Bello AK, Levin A, et al. National health policies and strategies for addressing chronic kidney disease: data from the International Society of Nephrology Global Kidney Health Atlas. PLOS Glob Public Health. 2023;3(2):e0001467. doi:10.1371/journal.pgph.0001467